Opinion: Byzantine system of child death reviews fails bereaved families

Sarah O'Donnell, Edmonton Journal11.27.2013

Human Services Minister Dave Hancock and his boss, Premier Alison Redford, are progressive leaders well suited to tackling the job of overhauling the death review system for children in government care.

When the unthinkable happens and a child in government care dies, there are two questions that should be easily answered in the horrible aftermath: Who will investigate the death? And how will the child’s family and the public be informed of the results of that review?

Of all the complexities that surround the lives of children in care, the death review process, at least, should be clear.

A landmark investigation by Edmonton Journal reporter Karen Kleiss and Calgary Herald reporter Darcy Henton into the deaths of children in care between 1999 and June 2013 has shown those two basic questions about accountability are so difficult to answer that it took four months just to pull together a snapshot of who investigates a child’s death in Alberta and how any information about that death gets reported — if at all.

What emerges is a picture of a Byzantine, largely secretive system that involves at least six groups that have some role in reviewing some, or all, of the child welfare deaths. Those groups, which rarely share information with each other, are governed by two ministries, three different laws and a good measure of unwritten rules.

An extensive investigation of the 145 deaths found those reviews, in practice, are something quite different than the process described by Human Services Minister Dave Hancock in the legislature Monday.

Yes, Alberta’s child and youth advocate, the council for quality assurance and the medical examiner all have the ability to look at these deaths. But both the medical examiner and the council for quality assurance see a fraction of the puzzle, receiving only information about children directly under government care.

The medical examiner’s work is not reported publicly. And the chairman of the council for quality assurance says it does not focus on systemic issues or child welfare deaths specifically to avoid duplication within a patchwork quilt of a system. The quality assurance group has never used its power to call an expert panel on child deaths, and the child advocate has conducted only two investigations so far, both into teen suicides.

Even the families of dead children can be in the dark as to basic information about their child’s death.

The mantra of the Redford government has been openness, accountability and transparency. If the Progressive Conservatives look at the current child death review system honestly, they will have to see it fails on all three counts.

There have been some steps in the right direction. As of 2012, the child advocate, now an independent officer who reports directly to the legislature, is informed of the deaths and serious injuries of all children in government care, as well as children who are receiving some help from children’s services but are still living with their families. Finally, in annual reports, Albertans can see a more accurate picture of how many children in care died of mishap, illness or something more sinister.

But right now, resources to review and investigate child deaths are spread over too many groups, and that is not even taking into account police investigations that often occur after a child death.

For all the money Alberta must spend on all these committees, review boards and inquiries, we could have a single, state-of-the-art review system that studies all child deaths — not just those connected to the child welfare system — looking for trends and making recommendations to help all Alberta families and guide government policy.

That system should be independent, and bring together experts in social work, pediatrics and policing, to name just a few. This multidisciplinary approach is key because a social worker will recognize different systemic problems than a police officer, but both are essential to ensure we accurately identify problems.

This is a provincial government looking to find efficiencies. The Human Services ministry was created for the very purpose of avoiding duplication within provincial social services and eliminating long-standing arbitrary and unnecessary barriers. Premier Alison Redford and PC MLAs have talked proudly of their results-based budgeting initiative.

The secretive, convoluted child death review system would be a good place to start seeking simplicity and transparency.

If this week’s question period and debate in the legislature showed one thing, it is that all parties believe in the critical mission of protecting Alberta’s children.

The roundtable discussion that Hancock announced Tuesday to talk about the deaths of children in care has promise, but it will fail unless it kick-starts an overhaul of the sad, but essential, death review process.

Hancock and Redford are progressive and compassionate leaders capable of tackling the job.

Redford has shown she can lead the country on the complex energy file. Now is the time for her to prove she can lead nationally on this even more difficult and emotionally charged question of protecting our most vulnerable.

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Opinion: Byzantine system of child death reviews fails bereaved families

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